Blood Pressure ; Blood Pressure Determination ; Coronary Angiography ; Coronary Artery Disease ; Diabetes Mellitus ; Humans

BACKGROUND: Measurement of coronary flow velocity in clinical caes contributes to understanding the pathophysiology of coronary circulation. To evaluate the coronary hemodynamics, we analyzed the pattern of coronary flow velocity with a new device consisting of 15Mhz piezoelectric transducer integrated into the tipped 0.018 inch or 0.014 inch flexible, steerable angioplasty guidewire. METHOD: A low profile(0.018 in. or 0.014 in.) Doppler angioplasty guidewire was used to measure the basal blood flow velocity in proximal coronary artery after intracoronary infusion of 200µg nitroglycerine, hyperemic blood flow velocity after intracoronary infusion of adenosine(12µg for LCA, 6µg for RCA). We measured several parameters such as APV (average peak velocity, cm/sec), DSVR(diastolic systolic velocity ratio), MPV(maximal peak velosity, cm/sec), PVI(peak velocity integral, cm), SPVI(systolic peak velocity integral, cm), DSIR(diastolic systolic integral ratio), ASPV(average systolic peak velocity, cm/sec) in basal and hyperemic states. This measurements were made in 17 patients undergoing coronary angiography. RESULTS: 1) APV, ADPV, MPV, in the basal state were higher in LCA than in RCA(32.1±16.6, 40.0±23.6, 57.1±29.0/15.8±9.1, 17.1±10.2, 24.5±20.9cm/sec) and DSVR was also higher in LCA(2.7±2.1/1.4±0.6). But ASPV and SPVI was not different(p>0.05). Significant increases in APV were noted in LCA(32.1±16.6→60.6±17.6cm/sec) and in RCA (15.8±9.1→42.1±15.5cm/sec) after adenosine infusion compared with basal state. DSVR measured in basal state were not statistically different from values in hyperemic state in LCA and RCA(2.7±2.1→2.3±1.7, 1.4±0.6→1.4±0.5, p>0.05). CONCLUSION: The blood flow patterns in both coronary arteries showed different biphasic flow patterns and this finding might be due to the pressure gradient during diastolic phase of both ventricles.
Adenosine ; Angioplasty ; Blood Flow Velocity ; Coronary Angiography ; Coronary Artery Disease ; Coronary Circulation ; Coronary Vessels ; Hemodynamics ; Humans ; Methods ; Nitroglycerin ; Transducers

PURPOSE: The purpose of this study was to investigate the knowledge and learning needs on coronary artery disease in diabetic patients by glycemic control. METHODS: The subjects consisted of 188 patients at the hospital who had diabetes mellitus. Data was obtained using a knowledge and learning needs questionnaire from January to April 2006. RESULTS: Treatment method, the levels of fasting blood glucose(FBG), and 2-hour postprandial blood glucose (PP2hr) showed meaningful differences between normo-glycemic group(HbA1c<7%) and hyper-glycemic group (HbA1c> or =7%). The levels of knowledge on coronary artery disease by glycemic control tend to show higher in normo-glycemic group. Etiology and prevention of coronary artery disease were significantly higher in normo- glycemic group than in hyper-glycemic group. The levels of learning needs on coronary artery disease by glycemic control tend to show higher in normo-glycemic group. The learning needs on items of diet control were higher in normo-glycemic group than in hyper-glycemic group. CONCLUSION: On the base of these results, we should focus on the coronary artery disease education for hyper-glycemic group. Also individual coronary artery disease educational program should be developed for the patients with different level of knowledge and learning needs.
Blood Glucose ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Diabetes Mellitus ; Diet ; Education ; Fasting ; Humans ; Learning* ; Surveys and Questionnaires

OBJECTIVE: To evaluate the role of oxidative stress and inflammation in the development of plaque rupture. METHODS: One hundred and ten patients enrolled in this study. All patients underwent coronary angiography. It included 85 patients with coronary heart disease (CHD) and 25 controls. The angiographic morphology of plaques was analyzed. According to the morphologic types of plaque, CHD patients were divided into Type I (smooth borders) group (n=31), Type II (irregular lesions) group (n=35), and Type III (long lesions) group (n=19). All patients were measured of MDA-LDL, hs-CRP, creatine kinase (CK), and MB isoenzyme of CK (CK-MB) in the plasma. RESULTS: Plasma MDA-LDL and hs-CRP in the Type II group were significantly higher than those in the control group, Type I group, and Type III group (P<0.01). The plasma levels of MDA-LDL were not correlated to LDL and HDL in patients in Type II group (P>0.05). The plasma levels of MDA-LDL and hs-CRP had a significant positive correlation in patients in Type II group (r=0.630, P<0.01). CONCLUSION Oxidative stress and inflammation may cause plaque rupture in CHD patients. The oxidative stress is likely to either induce or intensify the inflammatory action, and may co-affect with inflammation factors to cause or accelerate plaque rupture.
Coronary Angiography ; Coronary Artery Disease ; blood ; diagnostic imaging ; pathology ; Coronary Vessels ; pathology ; Humans ; Inflammation ; Inflammation Mediators ; blood ; Oxidative Stress

Apolipoprotein A-I ; blood ; Apolipoprotein B-100 ; blood ; Biomarkers ; blood ; Coronary Artery Disease ; blood ; Humans

OBJECTIVETo explore the relationship between plasma microRNA126 (miR-126) level and coronary collateral circulation (CCC) formation and to determine whether the miR-126 in plasma could serve as a blood-based biomarker for CCC in patients with severely narrowed coronary arteries (CAD).

METHODSIn this prospective study, a total of 120 consecutive CAD patients with ≥ 95% stenosis in one epicardial coronary artery were enrolled. Thirty healthy people served as normal control. They were divided into two groups according to Rentrop grades: patients with grade 2 and 3 collateral development (good CCC group, n = 64) and patients with grade 0 and 1 collateral development (poor CCC group, n = 56). Plasma miR-126 was measured by RT-PCR and serum VEGF was evaluated by ELISA method.

RESULTSFasting plasma glucose (FPG) was significantly lower in patients with good CCC than in patients with poor CCC ((5.99 ± 1.48) mmol/L vs. (6.40 ± 2.50) mmol/L). Plasma miR-126 levels and VEGF levels were significantly lower in CAD patients than in healthy people (0.04 ± 0.01 vs. 0.07 ± 0.02, P = 0.023 and (2 110 ± 455) ng/L vs. (2 574 ± 450) ng/L, P = 0.011, respectively). miR-126 and VEGF levels were significantly higher in good CCC group than in poor CCC group (miR-126: 0.06 ± 0.02 vs. 0.03 ± 0.01, P = 0.021;VEGF:(2 549 ± 614) ng/L vs. (1 759 ± 452) ng/L, P = 0.008) . In CAD patients with good CCC, the miR-126 level was positively correlated to the VEGF expression (r = 0.712, P = 0.005) while there was no correlation between miR-126 level VEGF in CAD patients with poor CCC (r = 0.342, P = 0.483) . Multivariate analysis revealed that plasma miR-126 (OR = 2.145, 95% CI 1.691-2.988, P = 0.001) and VEGF (OR = 1.279, 95% CI 1.068-2.295, P = 0.013) were independent predictors of collateral formation in patients with severely narrowed coronary arteries. In CAD patients, the area under the miR-126 ROC curve is 0.951 (P = 0.002).

CONCLUSIONPlasma miR-126 level is positively correlated to the CCC formation and is an independent predictor of CCC development in patients with severely narrowed coronary arteries, suggesting that plasma miR-126 might be a useful new, stable blood biomarker for predicting CCC formation in patients with severely narrowed coronary arteries.

Biomarkers ; Collateral Circulation ; Coronary Angiography ; Coronary Artery Disease ; blood ; Coronary Circulation ; Coronary Disease ; Heart ; Humans ; MicroRNAs ; blood ; Multivariate Analysis ; Plasma ; Prospective Studies ; ROC Curve

Coronary Disease ; blood ; pathology ; Female ; Humans ; Male ; Tongue ; pathology

Biomarkers ; blood ; Cell-Derived Microparticles ; metabolism ; Coronary Disease ; blood ; Humans ; Inflammation ; blood

BACKGROUND: The characterization of normal coronary blood flow dynamics should provide crucial guidelines for the accurate functional assessment of diseased coronary artery. However, the regional characteristics of coronary blood flow dynamics in normal human coronary artery have not been fully evaluated. METHODS: We performed proximal and distal segment velocity measurement of angiographically normal left anterior descending(LAD) and right coronary artery(RCA) in 25 patients(14 males, 12 females, age 50+/-10 yesre) with atypical chest pain. Spectral flow velocity parameters including average peak velocity(APV), average diastolic peak velocity(ADPV), average systolic peak velocity(ASPV), and diastolic-to-systolic velocity ratio(DSVR) were measured using 0.014 inch 15MHz Doppler wire at baseline and intracoronary adenosine-induced maximal hyperemic state. Coronary flow reserve(CFR) was calculated from the ratio of hyperemia to baseline APV. RESULTS: Comparison between LAD with RCA. LAD showed significantly higher APV than RCA at baseline(proximal ; 18+/-6cm/s vs 14+/-4cm/s, p<.005, and distal ; 17+/-6 cm/s vs 12+/-4cm/s, p<.005. LAD showed significantly higher ADPV and lower ASPV than RCA, therefore significantly higher DSVR than RCA> CFR was significantly lower in LAD than in RCA(proximal ; 301+/-0.9 vs 3.8+/-1.0 , p<3001, and distal ; 3.1+/-0.7 vs 3.6+/-0.8, p<.05). Comparison between proximal with distal segment. There was significant reduction in APV and ASPV from proximal to distal segment in RCA, but not in LAD. There was significant increase in DSVR from proximal to distal segment in RCA, but not in LAD. There was no difference in CFR between proximal and distal segment in both coronary arteries. CONCLUSION: We measured coronary blood flow velocities in angiographically normal coronary artery to characterized normal coronary blood flow dynamics and provide the reference values for the assessment of coronary artery disease. Significant regional differences of coronary blood flow velocities should be considered when we assess the diseased coronary artery.
Blood Flow Velocity ; Chest Pain ; Coronary Artery Disease ; Coronary Vessels* ; Female ; Humans ; Hyperemia ; Male ; Reference Values

BACKGROUND: High plasma levels of coagulation factor VII (FVII) are associated with a risk of coronary artery disease (CAD). Plasma FVII levels are influenced by environmental and genetic factors. We investigated whether the risk of CAD is associated with R353Q polymorphism and whether this polymorphism is associated with factor VII activity METHODS: We analysed plasma levels of FVII:C and FVII genotype for R353Q polymorphism in 85 CAD patients, 63 healthy controls, and 27 patient controls. And total cholesterol, HDL-cholesterol and triglyceride were measured in the same study populations. RESULTS: There was no difference among CAD patients, healthy controls, and patient controls in plasma levels of FVII:C. Allele Q of the R353Q polymorphism was less frequent in CAD patients (11.8%) than healthy controls (17.5%), although the difference was not statistically significant. Patients with the RQ genotype had a decreased risk of CAD (odds ratio, 0.29). There was no association between R353Q polymorphism and plasma levels of FVII:C. Plasma levels of FVII:C were positively correlated with total cholesterol and triglyceride. CONCLUSIONS: Our findings suggest that R353Q polymorphism may confer significant protection from CAD and that plasma levels of FVII:C may influenced by total cholesterol and triglyceride.
Alleles ; Blood Coagulation Factors* ; Cholesterol ; Coronary Artery Disease* ; Coronary Vessels* ; Factor VII* ; Genotype ; Humans ; Plasma ; Triglycerides